Roving paramedic won’t wait for 911 call to give aid

EVERETT — When 911 comes calling in south Snohomish County this year, paramedic Shane Cooper won’t be heading out to help.

The veteran firefighter is going to try a different approach to saving lives — a strategy that seems as simple and commonsense as it is cutting-edge.

Essentially, he’ll be trying to prevent the emergency medical calls from happening in the first place.

Cooper will make home visits to some of the most frequent 911 callers in the sprawling Snohomish County Fire District 1. The difference is that he’ll see those people before there’s an emergency, when adrenaline isn’t running high and seconds don’t count.

Instead of a crisis, there will be a conversation.

Cooper is set to become the proverbial fence at the top of the cliff rather than the ambulance at the bottom, a rarity in his traditionally reaction-driven line of work.

The concept of a roving community-based paramedic is being used in Australia, Europe and Canada with success, Fire District 1 Capt. Shaughn Maxwell said.

“For us, the alternatives have been leave them at home or take them to the hospital,” Maxwell said. “Now, we have a third alternative — let’s really solve their problem.”

Take elderly patients who are prone to falls. Nationwide, every 17 seconds on average, someone over the age of 65 falls and needs to go to the hospital. During a three-hour period in Edmonds alone last week, five elderly people experienced falls resulting in 911 calls. With an increasing aging U.S. population, 911 calls for falls are expected to become more frequent.

Part of Cooper’s job will be to inspect homes and look for solutions, such as making arrangements to get rails installed or carving a clear path through a living room or down a hallway.

He’ll work with asthma patients, looking inside the home for potential triggers to their breathing problems. He’ll spend time with people living with diabetes and others who are medically vulnerable. Often, he’ll try to connect patients with services in their communities.

Maxwell believes Cooper could be the first community paramedic based at a fire department in the state.

“They have tried it with hospitals, but a fire department has never gone to this level with a paramedic,” he said. “On some level, we are breaking new ground.”

Fire District 1 serves roughly 200,000 people and gets about 20,000 emergency calls a year. A few dozen people generated more than 400 of those calls, the district’s analysis found.

“If we can focus on the 50 people and concentrate on their needs, all citizens will benefit,” Maxwell said.

The time Cooper spends helping frequent callers is expected to free up paramedics for other calls. Fire district officials hope that will result in reduced response times.

Cooper’s list of stops also will include recent fall patients, people who have called 911 more than once in a 24-hour period and referrals from other paramedics and firefighters who have been inside homes and have seen a need.

“I see this as an early health-care warning system,” Maxwell said.

To Maxwell, the community paramedic program has the same life-saving potential as sprinklers and smoke alarms.

Fire District 1 is making arrangements to work with a university and emergency medical services department out of Hamilton, Canada, which also has a community paramedic program. The goal of the research is to help other fire departments replicate what works, Maxwell said.

As for Cooper, he said he is looking forward to going into homes and sitting down for some chats. He’ll be equipped if medical emergencies arise.

“For the most part, my office is going to be rolling in my rig,” he said.

Cooper drives an SUV well stocked with medical supplies. It will allow him, for instance, to reach patients in icy conditions and in power outages when ventilators could fail or oxygen tanks run empty.

Even before he makes his first home visit, which could happen as early as Monday, Cooper feels somewhat overwhelmed. Word of mouth has created a long list of requests.

At the same time, volunteer and social service agencies look to Cooper as a new avenue to reach people in need.

“I’ve got business cards coming out of my ears,” Cooper said. “They don’t see what we see. They only see the people when they come in for help.”

To get the paramedic house call program off the ground, Fire District 1 received grant money from the Verdant Health Commission, an offshoot of the Lynnwood-based Snohomish County Public Hospital District No. 2. The commission is providing $144,426 a year over two years.

Jennifer Piplic, a Verdant spokeswoman, said the commission wanted to support the initiative because of its innovation, emphasis on prevention and goal of hooking up people with the help they need.